Endocrine Abstracts

Background: Health inequalities persist in Paediatric type 1 diabetes care. The latest NPDA showed Cardiff and Vale had the lowest uptake of advanced technologies such as Hybrid Closed Loop (HCL) systems among children and young people (CYP), with 30% from deprived areas and 20% ethnic minorities.

Objectives: This project explores disparities in access to diabetes technology amongst those who are socioeconomically deprived and/or from ethnic minorities in Cardiff, identifies key barriers, and proposes QI-based interventions.

Methods: Data on CYP not using HCLs, including ethnicity and postcodes, was extracted from the database. Socioeconomic levels were stratified using deprivation indices from the Office for National Statistics. HbA1c levels were compared across these groups to assess correlations. Email surveys assessed family awareness and barriers to HCLs, with handouts and follow-up calls addressing digital literacy. MDT surveys identified perceived barriers, potential solutions, and were thematically analysed.

Results: HbA1c levels varied significantly by deprivation, with the lowest mean (64.77, n = 30) in the 0–13.4% range (least deprived) and the highest (86.58, n = 12) in the 26–56% range (most deprived). However, a weak correlation (r=0.29) suggests ethnicity may play a larger role. HbA1c differences were seen across ethnicities: Arab patients had the highest mean (99), followed by mixed (91) and black (75), whilst Asian (50.5) and white (69.7) CYP had the lowest. Family surveys showed 55.6% were unfamiliar with HCLs, but 89% were open to using them once they were informed. 33% cited lack of knowledge and 16% mentioned lifestyle compatibility as concerns. Peer support groups were suggested. All MDT members observed uptake disparities, citing language, travel costs, and phone requirements as the main causes. Proposed solutions included translated materials, more MDT time, targeted group sessions, and financial aid for phones and travel.

Conclusions: Despite strong interest in HCLs, barriers such as financial and access constraints, along with a lack of awareness, hinder uptake. Tailored support and education including translated materials, poverty proofing training for the MDT, and peer support are planned to ensure that CYP living in poverty or ethnic minorities are not excluded from accessing life improving diabetes technology.